Kornimate/medical-research-clean huggingface dataset:
interest of virtual reality for the management of hospitalized pregnant patients at risk of preterm delivery

Conditions: High Risk of Preterm Delivery

Summary: patients at high risk of preterm birth are hospitalized with an high stress for their child's future. in order to better prepare the patient to a possible preterm delivery we use to propose her a visit of the neonatology unit. however, as a result of their obstetrical condition and of the pediatric staff disponibility, this visit is not always possible. virtual reality (vr) is well known to provide an immersive experience while staying in a unique place. our project is to propose a virtual visit of the delivery room, neonatology unit and intensive care unit to all hospitalized patients at risk of preterm delivery in order to prepare and decompress them.

most of the future parents are unprepared to outcomes of their premature child and the neonatology unit visit has a demonstrated anxiolytic effect on them (decrease of 6.7 points on the state trait anxiety inventory-form y scale (stai-y1)) unfortunately, as a result of their obstetrical condition and of the pediatric staff disponibility, the visit of the neonatology unit is not always possible in time. furthermore vr is known to be an immersive experience wich had already proved its comforting interest during delivery or to prepare patient to a planned caesarean. in this study we propose to all hospitalized and high risk of delivery early patients a virtual visit of the neonatology unit from their sit in the calm space of their room. if the patient doesn't tolerate or has some vr contraindication : a virtual visit is possible on digital tablet. the visit is presented after the foetal lung maturation by 48h of betamethasone. patients complete a stai-y-a survey before and after the experience and a simulator sickness questionnaire (ssq) questionary to evaluate their tolerance. all medical informations can be found in the medical record.

Eligibility criteria:
inclusion criteria: * hospitalized patient * patient with high risk of preterm delivery * \> 24 week of gestation (wg) et ≤ 34 wg * patient who received corticosteroids for fetal lung maturation in the previous 24h * patient \> 18 years old exclusion criteria: * patient no speak french * no read french * \> 34 wg * guardianship, curatorship, or under the protection of a conservator * foetus vital prognosis engaged * medical contraindication to virtual reality: epilepsy, bipolarity, severe motion sickness ( evaluated by the patient herself : history of nausea, sweat, emesis during car, boat or airplane transportation ... +/- preventive therapy)

Keywords: virtual reality anxiety prematurity pregnancy
pediatric dose optimization for seizures in emergency medical services

Conditions: Seizures

Summary: the pediatric dose optimization for seizures in emergency medical services (pedidose) study is designed to improve how paramedics treat seizures in children on ambulances. seizures are one of the most common reasons why people call an ambulance for a child, and paramedics typically administer midazolam to stop the seizure. one-third of children with active seizures on ambulances arrive at emergency departments still seizing. prior research suggests that seizures on ambulances continue due to under-dosing and delayed delivery of medication. under-dosing happens when calculation errors occur, and delayed medication delivery occurs due to the time required for dose calculation and placement of an intravenous line to give the medication. seizures stop quickly when standardized medication doses are given as a muscular injection or a nasal spray. this research has primarily been done in adults, and evidence is needed to determine if this is effective and safe in children. pedidose optimizes how paramedics choose the midazolam dose by eliminating calculations and making the dose age-based. this study involves changing the seizure treatment protocols for ambulance services in 20 different cities, in a staggered and randomly-assigned manner. one aim of pedidose is to determine if using age to select one of four standardized doses of midazolam and giving it as a muscular injection or nasal spray is more effective than the current calculation-based method, as measured by the number of children arriving at emergency departments still seizing. the investigators believe that a standardized seizure protocol with age-based doses is more effective than current practice. another aim of pedidose is to determine if a standardized seizure protocol with age-based doses is just as safe as current practice, since either ongoing seizures or receiving too much midazolam can interfere with breathing. the investigators believe that a standardized seizure protocol with age-based doses is just as safe as current practice, since the seizures may stop faster and these doses are safely used in children in other healthcare settings. if this study demonstrates that standardized, age-based midazolam dosing is equally safe and more effective in comparison to current practice, the potential impact of this study is a shift in the treatment of pediatric seizures that can be easily implemented in ambulance services across the united states and in other parts of the world.


Eligibility criteria:
inclusion criteria: * witnessed by the paramedic to be actively seizing, regardless of seizure type or duration; and * under the care of a paramedic; and * transported by an ems agency participating in the study exclusion criteria: * a prior history of a benzodiazepine allergy; or * known or presumed pregnancy; or * severe growth restriction based on the paramedic's subjective assessment

Keywords: child emergency medical services
heart failure after heart transplantation due to chronic rejection

Conditions: Cardiac Allograft Vasculopathy; Chronic Rejection of Cardiac Transplant; Graft Dysfunction

Summary: this study will investigate the prevalence of allograft vasculopathy and unexplained graft dysfunction during long-term follow-up after heart transplantation. risk factors as well diagnostic approaches will be investigated.

during long-term follow-up heart transplant recipients are at risk of developing different complications that are likely to affect quality of life and survival. the most common cause of death during the later stages after heart transplantation is cardiac allograft vasculopathy, followed by unexplained graft dysfunction. in this study, advanced imaging techniques will be used to describe the frequency of these two complications, examine possible risk factors and study consequences on functional capacity and quality of life. further, the investigators will investigate whether it is feasible to screen for these conditions with non-invasive imaging methods. by studying patients that have performed cardiac transplantation between 10 and 20 years ago, the investigators expect to have a significant proportion of patients with these pathological conditions. methods that will be used include cardiac magnetic resonance imaging, coronary flow velocity reserve assessment, right heart catheterization and coronary imaging with angiography and optical coherence tomography.

Eligibility criteria:
inclusion criteria: * heart transplant performed more than 10 years and less than 21 years ago * scheduled yearly post-transplant control * signed informed consent exclusion criteria: * estimated gfr \< 30 ml/min/1,73m2 * radiographic contrast allergy * severe asthma or cold with fev1 \< 50% * second or third degree av block * pregnancy * in the investigator's opinion, the patient has a clinically significant disease that could be adversely affected by study participation
the pharmacokinetics of oral methadone in the treatment of neonatal abstinence syndrome

Conditions: Neonatal Abstinence Syndrome

Summary: the chronic use of opiate medications during pregnancy is a major public health challenge. prolonged exposure to opiates in utero may result in withdrawal symptoms in infants commonly referred to as neonatal abstinence syndrome (nas). signs of nas may include irritability, high-pitched crying, muscle tightness, seizures, diarrhea, vomiting, poor feeding, and unstable body temperature. many infants may be treated by supportive (non-pharmacological) therapy by minimizing stimulation, cuddling, responding promptly to hunger cues, and other comfort care. however, some infants continue to show severe symptoms of withdrawal despite these interventions. in these cases, infants may be treated with medications (pharmacological therapy). although it has been several decades since the first descriptions of nas, there still remains limited information with regards to the most effective treatment. we hypothesize that medical treatment protocols of nas with methadone can be optimized by better understanding what the body does to the drug (the population-based pharmacokinetics of methadone).


Eligibility criteria:
inclusion criteria: 1. chronic in utero exposure to opiates 2. term infant, greater than or equal to 37 weeks gestation 3. failure of non-pharmacologic treatment of nas 4. infant meets criteria for pharmacologic treatment of nas as determined by physical findings consistent with drug withdrawal and finnegan scoring system 5. the attending neonatologist chooses to treat the qualifying infant with oral methadone. exclusion criteria: 1. prematurity 2. congenital abnormalities 3. acutely ill neonates 4. confounding medical illness necessitating therapy with opiates other than for nas 5. neonates whose only exposure to opiates were narcotics administered during labor 6. infants who are wards of the state

Keywords: neonatal abstinence syndrome pharmacokinetics methadone neonate newborn
effect of vitamin d and denosumab on bone remodelling in women with postmenopausal osteoporosis

Conditions: Hypovitaminosis D; Osteoporosis, Postmenopausal; Menopause

Summary: denosumab is a monoclonal antibody against rankl ligand, which is used as an alternative treatment for osteoporosis in patients who have a poor response to first-line antiresorptive therapy. however, discontinuation of denosumab produces a rapid increase in bone turnover, bone loss and potentially increased risk of multiple vertebral fractures.

76 postmenopausal women from the climacteric clinic of the regional hospital "1o de octubre" of the institute of security and social services for state workers (issste) were firstly considered, of which 23 presented elimination criteria and only 55 who had received denosumab therapy for an average of 2.5 years without a significant improvement in hip and lumbar spine t-scores were enrolled. first, a general medical evaluation was performed. serum levels of vitamin d were analysed to find the prevalence of hypovitaminosis d. a bone mineral density test was done to calculate hip and lumbar spine t-scores. then, vitamin d was administrated daily for one year at a dose of 4,000 iu and the studies were repeated after one year. statistical analysis was performed using past 3.0 and graphpad prism 8.4.3. software. the arithmetic median (µ) and standard deviation (s.d.) were calculated using excel-word. graphics were constructed with graphpad prism 8.4.3 and tables with excel word. categorical variables were analysed with chi-squared or fisher exact test depending on the number of participants in each cell. normality was determined using the shapiro-wilk test. to compare two paired samples, the wilcoxon signed-rank test was utilized. the assigned α value for this study was \<0.05. in all cases, if a montecarlo permutation was available, the exact p-value was taken instead of the raw p-value.

Eligibility criteria:
inclusion criteria: * diagnosis of postmenopausal osteoporosis or osteopenia in treatment with denosumab 60mg every six months plus calcium carbonate 1.2g/day + vitamin d 800iu/day. * diagnosis of hypovitaminosis d, with serum cholecalciferol values \<30ng/dl. exclusion criteria: * incomplete clinical records or clinical records. * age over 90 years. * diagnosis of secondary (hereditary) osteoporosis. * history of prolonged use of steroids. * lack of adherence to medical treatment. * diagnosis of cancer. * diagnosis of depression. * diagnosis of celiac disease or with the presence of alterations in intestinal absorption. * allergies to any of the medications administered.

Keywords: vitamin d postmenopausal osteoporosis denosumab hypovitaminosis d osteoporosis osteopenia
comparison of dosimetry after rhtsh or withdrawal of thyroid hormone in metastatic or locally advanced thyroid cancer

Conditions: Thyroid Cancer; Metastases

Summary: metastases of thyroid cancer with iodine uptake are treated with repeated activity of i-131 administered after thyroid hormone withdrawal. the goal of thyroid hormone withdrawal is to treat patients with elevated thyrotropin stimulated hormone (tsh), a hormone secreted by the pituitary, a gland just located under the brain. another way to obtain elevated tsh levels is to perform intramuscular injection of recombinant human tsh, a hormone produced pharmaceutically. the goal of this study is to know whether the radioiodine uptake by the metastases is similar after rhtsh administration or after thyroid hormone withdrawal.

patients will undergo a rhtsh stimulation, staying on thyroid hormone treatment. following 2 administration of rhtsh an injection of i-124 will be performed. positron emission tomography with computed tomography scans (pet/ct), blood tests, and measurements of whole body radioactivity will occurred during the 4 to 96 hours following i-124 administration in order to perform dosimetry (i.e.) to estimate the radiation dose delivered to the metastases. after 4 weeks under thyroid hormones patients will undergo thyroid hormone withdrawal and a new administration of i-124 will be performed. the same dosimetry study will be realized with pet/ct, blood tests, and measurements of whole body radioactivity. a therapeutic activity of i-131will then be administered followed by whole body scan realized 24 to 72 hours after the administration of i-131. dosimetry studies will be compared in order to determine whether rhtsh stimulation can replace thyroid hormone withdrawal for the treatment of distant metastases.

Eligibility criteria:
inclusion criteria: 1. patients with thyroid cancer and known measurable (\>1cm) distant metastases demonstrating radioiodine uptake on a previous whole body scan 2. patients planned for a therapeutic activity of 131i after thyroid hormone withdrawal 3. age \>18 years 4. previous treatment with radioiodine more than 6 months before inclusion. 5. serum tsh level \<0.5 mu/l 6. normal renal function with a creatinine clearance estimation using the cockcroft-gault formula \> 60 ml/ml 7. effective means of contraception for female patient, at risk of pregnancy 8. written informed consent exclusion criteria: 1. patients whose majority of tumoral lesions disclose fdg uptake without radioactive iodine uptake 2. iodine excess (\< 50 μg/dl) 3. large or diffuse bone or brain metastases 4. patients with multiple small tumor foci less than 1 cm in diameter, such as miliary spread to the lungs 5. patients already included in a therapeutic trial with an experimental medicine 6. pregnancy and breast feeding patients 7. subject with any kind of disorder that compromises the ability of the subject to give written informed consent and/or to comply with study procedures 8. treatment with antivitamin k

Keywords: metastatic or locally advanced differentiated thyroid cancer planned for a therapeutic activity of 131i after thyroid hormone withdrawal
thohspekt thoracoscopic ectomy of radioactively marked pulmonary nodules with free-hand spect

Conditions: Solitary Pulmonary Nodule; Bronchial Neoplasms

Summary: title thohspekt study design pilot study concerning the technical operative methods and a phase ii study concerning the radiopharmaceutical (therapeutic-explorative study with an approved drug in a new indication) location kantonsspital st.gallen aim proof of feasibility of thoracoscopic ectomy of radioactively marked pulmonary nodules with the help of free-hand spect. background in the cantonal hospital of st.gallen an average of 30 - 40 patients will be operated with thoracoscopic ectomy for a pulmonary nodule. when localisation of the nodule is not possible a switch to minithoracotomy is performed. study intervention marking of pulmonary nodules with radioactivity. free-hand spect guided surgery risks risks of bronchoscopic or ct-intervention radiation risk (minimal) rational for patient number 10 patients for each group are enough to prove the feasibility, to manage difficulties and to record complications duration approximately 24 months.


Eligibility criteria:
inclusion criteria: * age over 18 years * planed thoracoscopic surgery of a pulmonary nodule * informed consent exclusion criteria: * mental incapacity * contraindications for this treatment * pregnancy

Keywords: solitary pulmonary nodule thoracoscopy thoracic surgery video-assisted radioactive tracers radioguided surgery handheld-spect
study to evaluate the response to enbrel and the impact of rheumatoid factor(rf) and anti-cyclic citrullinated peptide(anti-ccp) in rheumatoid arthritis(ra) patients

Conditions: Arthritis, Rheumatoid

Summary: this study is to evaluate available local data in iraqi patients with rheumatoid arthritis on enbrel treatment with regards to the impact of rheumatoid factor and anti-cyclic citrullinated peptide using data from the baghdad teaching hospital registry.


Eligibility criteria:
inclusion criteria: * diagnosed ra patients. -≥18 years of age * did not receive previous another biological treatment exclusion criteria: * had previous biological treatment * use of etanercept for less than 1 year
resistance training with blood flow restriction in hemophilia

Conditions: Hemophilia

Summary: the main objectives of this study are to evaluate safety and chronic effects of a low-load resistance exercise intervention (elbow flexions and extensions, and knee extensions) with blood flow restriction in people with hemophilia on quality of life, pain, and on physical and neuromuscular function.


Eligibility criteria:
inclusion criteria: * diagnosis of hemophilia a or b and undergoing prophylaxis; * willingness to exercise twice a week during the training program and to complete the pre- and post-program evaluations; * approval by their hematologist to participate in the exercise program; * age between 18 and 60 years; * informed consent signed. exclusion criteria: * the inability to attend exercise sessions at least twice a week for 8 consecutive weeks; * non adherence to instruction on proper exercise technique; * surgical procedures performed 6 weeks prior to or during the exercise program; - participation in any other form of exercise, not previously done, during the study; * changes in medication during the study; * a major bleeding episode that posed a risk or prevented exercise; * another hemostatic defect; * need for major surgery; * withdrawal of informed consent.

Keywords: hemophilia electromyography muscle activity resistance training
age-specific prevalence and comparisons of uds and bladder diary between oab-wet and -dry women

Conditions: Urinary Bladder, Overactive

Summary: the knowledge of the age-specific prevalence of overactive bladder syndrome (oab)-wet and -dry women is important for understanding the impact of aging on oab. thus, our aim is to describe clinically differences between oab-wet and -dry women.

between july 2009 and january 2018, all women with oab visiting a medical center for evaluation were reviewed. the classification of oab-wet or oab-dry is based on the record of the three-day bladder diary of each patient. the diagnosis of oab in each patient was based on the presence of at least one episode of urgency in her three-day bladder diary and with the absence of stress urinary incontinence. the presence of at least one episode of urgency associated incontinence was defined to be oab-wet, otherwise, oab-dry.

Eligibility criteria:
inclusion criteria: 1. more than 20-year-old 2. female 3. diagnosed with overactive bladder by bladder diary exclusion criteria: 1. younger than 20-year-old 2. pregnant or planned to be pregnant

Keywords: overactive bladder bladder diary
international device assisted controlled sequential elevation cpr registry

Conditions: Cardiac Arrest, Out-Of-Hospital

Summary: the purpose of this prospective observational cardiopulmonary resuscitation (cpr) registry is to track the use and clinical outcomes from emergency medical systems across the us and europe that have implemented a system of care approach applied rapidly to cardiac arrest that includes using the combination of an impedance threshold device (itd), and either manual active compression-decompression (acd) cpr device or automated compression device, with a head up cpr device.

in 2019, a fda approved patient positioning device capable of elevating the head and thorax in a controlled manner became commercially available. as emergency medical services are increasingly using this head up cpr patient positioning device as part of their standard protocol for cardiac arrest patients, in addition to active compression-decompression (acd) cardiopulmonary resuscitation with an impedance threshold device (itd) cpr or with mechanical cpr and the itd, it is important to monitor how this device is being used, and outcomes of patients who received this head up cpr therapy. all of the devices used in this observational registry study have received fda 510k clearance. emergency medical systems (ems) that have implemented standard cardiac arrest protocols that include the combination of manual cpr with an itd, an automated cpr device with the itd, or acd+itd cpr, with the head up cpr device are asked to be part of the registry. if a system participates, they are asked for de-identified cardiac arrest data including patient demographics, details of cardiac arrest care, and patient outcomes before and after implementation of the head up cpr bundle. de-identified data is kept securely by the study sponsor and pi. the patient data for all systems using this approach to resuscitation are included, with a current focus on patients receiving the device combination rapidly.

Eligibility criteria:
inclusion criteria 1. patient is at least 18 years of age 2. patient is in active cardiac arrest, as defined by presence of either ventricular fibrillation or ventricular tachycardia, or pulseless electrical activity, or asystole at time of enrollment. 3. patient receives either a) active-compression decompression cardiopulmonary resuscitation b) automated suction-cup based cpr with an impedance threshold device (itd) c) manual cpr with an itd 4. subject receives device assisted controlled elevation of the head and thorax. exclusion criteria 1. prisoners